Diagnosis

Thoracic aortic aneurysms are often found during routine medical tests, such as a chest X-ray or ultrasound of the heart or abdomen, sometimes ordered for a different reason.

If your doctor suspects that you have an aortic aneurysm, specialized tests can confirm it. These tests might include:

Chest X-ray. Your doctor may first suspect you have a thoracic aortic aneurysm by looking at chest X-ray images. Your doctor may discover a thoracic aortic aneurysm on X-ray images ordered to check for another condition.

Echocardiogram. Thoracic aortic aneurysms may be diagnosed by echocardiogram, and this technique is often used to screen family members of those with thoracic aortic aneurysm. An echocardiogram uses sound waves to capture real-time images of your heart and the ascending aorta.

Echocardiograms show how well your heart chambers and valves are working. Occasionally, to better see your aorta, your doctor may recommend a transesophageal echocardiogram — in which the sound waves are generated from within your body by a device threaded down your esophagus.

Computerized tomography (CT) scan. This painless test can provide your doctor with clear images of your aorta, and it can detect the size and shape of an aneurysm. During a CT scan, you lie on a table inside a doughnut-shaped machine. CT scanning generates X-rays to produce cross-sectional images of the body. Doctors may inject a dye into your blood vessels that helps your arteries to be more visible on the CT pictures (CT angiography).

One downside of the use of CT in detecting and following aortic aneurysms is the exposure to radiation, particularly for people who require frequent monitoring, such as those with Marfan syndrome. However, newer CT scan techniques may be used to reduce your radiation exposure at some medical centers.

Magnetic resonance angiography (MRA). An MRA is a painless imaging test that may be used to diagnose an aneurysm and determine its size and location. In this test, you lie on a movable table that slides into the tunnel. An MRI uses a magnetic field and pulses of radio wave energy to make pictures of the body. Doctors may inject a dye into your blood vessels to help your blood vessels to be more visible on images (magnetic resonance angiography).

This test may be an alternative to CT scans for people who need frequent monitoring, to reduce their exposure to radiation.

Screening for thoracic aortic aneurysms

Conditions that cause a thoracic aortic aneurysm may run in families. Because of this, your doctor may recommend you have tests to check for thoracic aortic conditions if a first-degree relative, such as a parent, sibling, son or daughter, has Marfan syndrome or another condition that could cause a thoracic aortic aneurysm. These tests may include:

Imaging tests. Your doctor may recommend that your first-degree relatives have an echocardiogram or another type of imaging test to check for Marfan syndrome or another thoracic aortic condition. If your doctor finds you have an enlarged aorta or an aneurysm, you'll likely need another imaging test within six months to make sure your aorta hasn't grown larger.

Genetic testing. If you have a family history of Marfan syndrome, or another genetic condition that raises your risk of thoracic aortic aneurysm, you may want to consider genetic testing. You may also want to consider genetic counseling before starting a family.

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